9/10: Disaster Preparedness in the Aftermath of 9/11

Nine years after the September 11th attacks on the World Trade Center, how prepared is America for a terrorist attack? Dr. Irwin Redlener heads the National Center for Disaster Preparedness at Columbia University, and he talks with the Marist Poll’s John Sparks about this and where he was on the day of the attacks.

Dr. Irwin Redlener

Listen to the interview or read the transcript below.

John Sparks
Dr. Redlener, this week will mark the 9th anniversary of the September 11th attacks on the World Trade Center. Do you recall where you were and what you were doing then?

Irwin Redlener, MD
I do. I was at home with my wife. We both were working at the Children’s Health Fund and at Montefiore Medical Center at the time. I was president of a new children’s hospital, and we heard the first reports of the first plane going to the World Trade Center, and we were operating under the assumption that it was a small plane that had accidentally crashed into the World Trade Center. Then, we got in the car and listened to the news and driving across the Bruckner Expressway and seeing smoke from downtown. We were coming down from Westchester. It was apparent obviously that it was — something was far more worrisome than we originally thought, and we were hearing the reports about the — it was a jetliner and then it was two jetliners, both towers, and the collapse, and that’s what our experience was initially.

John Sparks
So what did you find yourself doing? Did you do anything to help out in response to the attacks?

Irwin Redlener, MD
Yes, my organization managed a — at that point was a growing national network of mobile clinics for medically underserved and disadvantaged populations, and we had a number of them, I think, at that point, four or five mobile clinics in New York City. So, I brought in the medical director, and I was — I’m president of the organization and Karen Redlener, my wife, is executive director, and we called in the medical director of our New York programs and asked him to organize two mobile units that we could send down to Lower Manhattan to be part of the triaging resources that were being developed down there.

John Sparks
So, you found yourself occupied for a number of days after that then I take it?

Irwin Redlener, MD
Yes.

John Sparks
The National Center for Disaster Preparedness that you head, was this operation you’re referring to that, at the time, grew into a more formal organization?

Irwin Redlener, MD
No, the National Center for Disaster Preparedness was initiated in 2003. But right after 9/11, and I got very interested and concerned about our ability to respond to large scale disasters, and I established, as I say, I was president of the Children’s Hospital at Montefiore at the time, and I established a pediatric preparedness program for mass casualty events at Montefiore at the Children’s Hospital there, and so, that was running and growing and was the reason that the School of Public Health at Columbia recruited me to come over to Columbia and set up this new entity, which I called the National Center for Disaster Preparedness.

John Sparks
The new entity today, what kinds of things does it oversee now? Obviously, we were all taken completely off-guard with the attacks. But I’m just curious what kind of preparedness that your National Center has developed since that time.

Irwin Redlener, MD
Well, first of all, we are concerned about the level of preparedness from top to bottom. We think that the policies and the resources are either inadequate or insufficient in a variety of ways at the top, and we think at the other end of the spectrum is a very unprepared citizen population with respect to what to do about disasters. And, in between a lot of confusion about the role of state versus federal versus local government and so forth. So, our center works on trying to sort out these issues with a goal toward making both local communities, but the country as a whole, prepared to deal with — either prepared to — able to prevent or prepare to deal with the consequences of disaster. And recently we’ve gotten interested in the issue of recovery from large scale disasters which is basically almost an untouched aspect of preparedness that has to be now thought of in a lot more rigor than had been in the past.

John Sparks
So, nine years later, how prepared are we today to handle a similar event?

Irwin Redlener, MD
It’s a very mixed bag because in some ways we’re better, in some ways we haven’t made much progress, and there’s a lot to be concerned about still. So, I think the report card would be a mix of passing and failing grades. I think we’re just at a point now where we’re starting to see more inter-operability among radio systems used by various respond organizations, like police and fire and EMS, but that’s been a long time in coming, and we’ve gotten more training for more people who are first responders, and that’s good. We’ve made almost no progress in the level of preparedness of individuals. If we had an exact repeat of the 9/11 events, there would be a lot of confusion about whether or not we’re going to have rescue and relief workers rushing into the pile, so to speak, as we had previously because we now know a lot more about the potential long-term consequences in terms of medical problems that arise from people who are working in unprotected ways and even the immediate search and rescue. So, there’s a lot that’s different, but a lot that really remains as challenges. Another instant issue is hospital preparedness, and we’ve made some progress there, but we’re very, very far behind on that aspect of where we should be now too. So, it’s hard to give a straight answer, simple answer, but that’s where we are.

John Sparks
You mentioned individuals, I wanted to ask you what we as individuals can and should remember to do in case of an attack similar to what we experienced nine years ago.

Irwin Redlener, MD
Well, the recommendations have been pretty straightforward from soon after 9/11, which is to you know get a kit, make a plan and so forth about what you would do, and then know what the risks are and make — get a kit and make a plan for what you would do as individuals and as families, and the stockpiling of three days of food and water for each person who you’re responsible for. Those kinds of things are very straightforward. They’re found on — with the Red Cross site, on FEMA’s Web site and so forth, but there’s been very minimal uptake by the general public for even those basic directions, and part of that has to do with the fact that we don’t really know a lot about what motivates people to get prepared or not get prepared. But, we’re still in some serious dilemma with respect to how to improve the preparedness levels of individuals.

John Sparks
Interesting that you mention what motivates people. As we speak, the Marist Institute is out in the field polling New Yorkers and asking whether they still worry about another terrorist attack.

Irwin Redlener, MD
Yeah.

John Sparks
We don’t know the results of that poll quite yet. We’re out in the field with it, but I know that you certainly with your responsibilities are concerned about another attack. But, do you get the feeling that most New Yorkers still worry about another attack?

Irwin Redlener, MD
Not in any kind of overt way, and I think they’re more worried about jobs and that sort of thing than they are about a terrorist attack, and I think that’s not just New York. I think it’s probably true generally in the country.

John Sparks
Anything in particular that you might want to add that you’re looking into as an organization or trying to shore up in anticipation should we have another attack?

Irwin Redlener, MD
Well, one of the things I’m most concerned about is the state of hospital and health system readiness for a major attack or a bio-terrorism event, or even just a pandemic not caused by terrorism, and we just seem to be really struggling to find the resources to make — to really expand or to really enhance the level of preparedness, and that’s one of the things we are most definitely working on.

John Sparks
You know that reminds me that, as you recall, coincidental to the attack, we had the anthrax episodes. That kind of falls into hospitals, I think, because that’s clearly something that we don’t have under control either today.

Irwin Redlener, MD
That’s correct, so there’s more of these areas that we don’t quite have a handle on than I expected to be the case at this point.

John Sparks
Is there anything else that you want to add?

Irwin Redlener, MD
Yeah, one of the other big issues is that we haven’t spent enough time focusing on the needs of populations that might be particularly vulnerable and especially children. Our children make up 25% of the U.S. population, but they’re still very much marginalized when it comes to planning for major disasters, and that’s a problem because the needs of children can be very, very different medically and psychologically and everything else. And one of the things that has been done, a couple years ago there was an establishment of a National Commission on Children’s Disasters, which is a federally appointed body… I happen to be on it… that’s actually looking to that particular aspect of disaster planning and what are we doing for our children, and there’s quite a lot of work still left to be done in that arena as well.